Document Detail


Intrathoracic pressure regulation improves 24-hour survival in a pediatric porcine model of hemorrhagic shock.
MedLine Citation:
PMID:  21646939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemorrhagic shock is a common cause of mortality and morbidity in the pediatric population. Intrathoracic pressure regulation (IPR) lowers intrathoracic pressure, thereby decreasing intracranial pressure and increasing venous return, cardiac output, and cerebral perfusion without the need for immediate fluid resuscitation. We hypothesized that IPR would improve hemodynamics and 24-h survival in a pediatric porcine model of hemorrhagic shock. Twenty piglets were subjected to a 50% total blood volume hemorrhage over 15 min and then randomized to treatment with either IPR or no treatment. After 60 min, survivors were autotransfused, weaned from the ventilator, and assessed and autopsied at 24 h. Mean arterial pressures (MAPs), cardiac index (CI), and arterial blood gases were recorded. MAP (mm Hg) was significantly higher in the IPR group (60.8 ± 3.7) versus controls (41.2 ± 4.6, p < 0.01). Mean CI (L/min/m²) was significantly higher with IPR (3.9 ± 0.24) versus controls (2.5 ± 0.39, p < 0.01). IPR survival rates were significantly improved with IPR [9/9 (IPR) versus 5/11 (controls); p < 0.02]. In this piglet model of hemorrhagic shock, IPR treatment safely and significantly improved MAP, CI, and 24-h survival rates.
Authors:
Anja Metzger; Timothy Matsuura; Scott McKnite; Bradley S Marino; Vinay M Nadkarni; Demetris Yannopoulos
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric research     Volume:  70     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-08     Completed Date:  2011-12-06     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  267-71     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota 55455, USA. kohl0005@umn.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Child
Disease Models, Animal
Female
Hemodynamics
Humans
Pressure*
Random Allocation
Respiration
Shock, Hemorrhagic / mortality*,  physiopathology,  therapy*
Survival Rate
Sus scrofa
Thorax / physiology*
Ventilation / instrumentation,  methods
Grant Support
ID/Acronym/Agency:
5R43HL083541-02/HL/NHLBI NIH HHS; R43 HL083541-02/HL/NHLBI NIH HHS
Comments/Corrections

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